CSF profiles in meningitis - source BRS Pediatrics Flashcards
Acute bacterial meningitis CSF profile
WBC: 100-50000, PMNs predominate
High protein
Low glucose
Positive cx and gram staining
Partially treated bacterial meningitis CSF profile
1000-10000 WBC, monocytes predominate
Normal to hight protein
Low normal glucose
Negative cx, usually negative gram stain
Viral meningitis CSF profile
10-1000 WBC, PMNs early, then monos and lymphs
normal to high protein
normal glucose
Enterovirus may be recovered by culture, can identify by PCR, as can HSV
HSV encephalitis CSF finding different than typical viral meningitis CSF profile
may show RBCs
Identify HSV by PCR
Tuberculosis meningitis CSF profile
10-500 WBC, lymphs predominate
Very high protein
Low to very low glucose
AFB smear and cx rarely positive
PCR may be positive
Fungal meningitis CSF profile
25-500 WBC, lymphs predominate
Normal to high protein
Low glucose
Cx may be positive, India ink + with Cryptococcus
Parameningeal focus (brain abscess) CSF profile
10-200 WBC, polys or monos predominate
High protein
Normal glucose
Negative cx
CSF Profile:
100-50000 WBC, PMNs predominate
High Protein
Low Glucose
What is the likely pathogen/cause, and what definitive test should be ordered?
Acute bacterial meningitis
Order CSF cx and gram stain - both will be positive
CSF profile:
1000-10000 WBC, monocytess predominate
Normal to high protein
Low normal glucose
What is the likely pathogen/cause, and what definitive test should be ordered?
Partially treated bacterial meningitis
Order CSF bacterial antigens which should be positive, cx and gram stain usually negative
CSF profile:
10-1000 WBC, early in disease PMN predominate, then monocytes and lymphocytes
Normal to high protein
Normal glucose
What is the likely pathogen/cause, and what definitive test should be ordered?
Viral meningitis
Enterovirus may be recovered by cx, also may be identified by PCR
CSF profile: 10-1000 WBC, early in disease PMN predominate, then monocytes and lymphocytes RBCs Normal to high protein Normal glucose
What is the likely pathogen/cause, and what definitive test should be ordered?
HSV encephalitis
Possible traumatic tap with viral meningitis
Order PCR to identify HSV
CSF profile:
10-500 WBC, lymphocytes predominate
Very high protein
Low to very low glucose
What is the likely pathogen/cause, and what definitive test should be ordered?
TB meningitis
AFB smear and cx - rarely positive
PCR may be positive
CSF profile:
25-500 WBC, lymphocytes predominate
Normal to high protein
Low glucose
What is the likely pathogen/cause, and what definitive test should be ordered?
Fungal meningitis
Cx may be positive
India ink positive with Cryptococcus
CSF profile:
10-200 WBC, PMNs or monocytes predominate
High protein
Normal glucose
What is the likely pathogen/cause, and what definitive test should be ordered?
Parameningeal focus (brain abscess)
Cultures will be negative
